On October 22, 2015, individuals who had been found incompetent to stand trial on criminal charges filed this lawsuit in the United States District Court for the Middle District of Pennsylvania. The plaintiffs sued the Pennsylvania Department of Human Services, Norristown State Hospital, and Torrance State Hospital under 42 U.S.C. § 1983 and 42 U.S.C. § 12132 (the Americans with Disabilities Act). Represented by the ACLU of Pennsylvania and private counsel, they asked the court for class certification (a class of plaintiffs waiting in jails for placement and a class of plaintiffs in state hospitals who were unlikely to be declared competent) and declaratory and injunctive relief, including a preliminary injunction. The case was assigned to Judge Sylvia H. Rambo.

The individuals who were declared incompetent to stand trial suffered from a range of mental health issues, including intellectual and cognitive disabilities, traumatic brain injury, and mental illness, including serious mental illness and dementia. When a court would rule that an individual was incompetent to stand trial on criminal charges, it would stay the proceedings and then order treatment to restore competency. If, at some point, the individual became competent, the criminal charges could be reinstated. Once a court issued an order for competency restoration treatment, the person was transferred to a mental health facility to be treated. Upon issuance of the court order, responsibility for the criminal defendant was immediately transferred to the state’s Department of Human Services.

The plaintiffs claimed that DHS’s denial of timely treatment, and failure to address delays, violated the Due Process Clause of the Fourteenth Amendment, Title II of the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, the regulations promulgated under the ADA and the Rehabilitation Act, and court orders. Specifically, the plaintiffs claimed that DHS’s failure to allocate sufficient resources for providing competency restoration treatment resulted in some of the longest delays in the country: many criminal defendants waited more than a year, while some federal courts had deemed more than seven days’ wait unconstitutional). These delays caused the plaintiffs to spend time in jail, where there was minimal to no mental health care, and they often suffered in solitary confinement.

On January 27, 2016, the parties filed, and the court approved, a settlement agreement enforceable by the court for three years. The state agreed not to oppose class certification for those plaintiffs waiting in jails for placement. It also agreed to allocate necessary resources to remove currently incarcerated class members from jails, and to prevent future jail detentions beyond constitutionally allowable times, including the creation of new placement options and making at least $1 million available to create supportive housing opportunities in Philadelphia. The DHS would also assess every person on waiting lists for treatment at Norristown State Hospital or Torrance State Hospital, as well as every person currently confined at either hospital by order of a criminal court, to determine which criminal defendants were eligible for less-restrictive placement.

The parties agreed to postpone the impending preliminary injunction while they worked together to develop a strategic plan for reducing wait times and attempted to negotiate a maximum allowable wait time, which would be incorporated into the settlement agreement. The state agreed to pay the plaintiffs’ costs and attorneys’ fees.

On May 11, 2017, the plaintiffs, claiming that the state was failing to meet the requirements of the settlement, again moved for a preliminary injunction. Although the state had added additional resources as required by the settlement, the waitlist had grown and the wait times remained in excess of sixty days—which the state acknowledged was unconstitutional.

On June 15, 2017, the parties reached a second interim settlement agreement and the court dismissed the plaintiffs’ motion for a preliminary injunction. Under the second interim settlement agreement, the state agreed to hire an independent consultant to conduct an assessment of the state’s competency restoration systems and processes and produce a report with a recommended strategy to reduce wait times to constitutional levels. The state also agreed to add additional resources for class members over the following nine months. Following the completion of the consultant’s report, the state agreed to implement the plan or propose alternative strategies to the plaintiffs. If the parties were unable to reach an agreement, the plaintiff might again move for a preliminary injunction. The parties also agreed to attempt to reach an agreement on a maximum allowable wait time for mentally ill criminal defendants. In addition, the state agreed to pay the costs and consulting fees of the independent consultant, as well as the plaintiffs’ attorneys’ fees.

On March 19, 2019, the plaintiffs filed a renewed motion for a preliminary injunction, alleging that the state was failing to address the unconstitutional wait times. The plaintiffs requested that the court compel the state to transfer all class members to a mental health facility within seven days of the filing of a commitment order. On April 23, 2019, the state filed a response to the plaintiffs’ motion, arguing that seven days was not an appropriate legal standard, and that DHS needed twenty-one days to transfer incompetent patients.

The parties began renewed settlement discussions and the court stayed the proceedings, pending a settlement agreement, on June 3, 2019. On June 22, 2020, the court approved a joint motion to extend the second interim settlement agreement for 6 months while negotiations continued on a third settlement agreement. As of July 23, 2020, those negotiations are ongoing.

Katrina Fetsch - 02/21/2016
Cade Boland - 03/06/2018
Dan Toubman - 04/12/2020


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